Personal Directive. Why bother?

*** Time for this post?  Reading… 12 minutes. Viewing…13 minutes well spent. Doing the work…take the time while you have it.

A Personal Directive (Advance Directive, Health Care Directive, Living Will) is an important piece of your paperwork. It’s the legal document in which you state your wishes for your personal care and medical treatment…or non-treatment. It only comes into effect if you are found to lack capacity to make personal decisions for yourself.

You need a Personal Directive as well as your Power of Attorney. Although both of them come into effect when you’ve lost your mental capacity to decide for yourself, the Power of Attorney can only address your financial matters. So a Personal Directive is necessary to give authority to someone you trust to make your personal decisions.

It’s about directing how you want your life to conclude…

Jim McDermott is a medical doctor who has seen plenty of life and death. In a compelling TEDx talk, he reminds us of the importance of initiating conversations about how we wish to pass when the time comes. He encourages us to think and act on our own convictions while we can, putting our wishes in writing so they are known by all who will be caring for us.

As Dr. McDermott says, you go to the trouble of documenting your wishes for…
  1. Yourself… so you go in the best possible way.
  2. Your loved ones… to clarify your wishes and prevent emotionally upsetting disputes about what is best.
  3. Your doctors…to free them from their ethic of prolonging life at all cost.
  4. Your wallet…to prevent unproductive expenditures on treatments that make very little difference in the long run.

Making an Advance Care Plan…

Putting your wishes in writing isn’t easy—he’s right about that!

For me, my Personal Directive was challenging because it took a while to find helpful information about how to do it. Not because there wasn’t information, but because it was written by medical people and government officials. The resulting booklets were confusingly clinical. They did nothing to help me think about what life might bring when I’m old and frail…or what I think should happen in such circumstances. Nor did they help me gain a sense of when I would be ready to say “enough is enough.”

Dying with Dignity…

Then I discovered Dying with Dignity Canada, an organization committed to improving our quality of dying, protecting end-of-life rights, and helping Canadians avoid unwanted suffering.

Dying with Dignity has a booklet that is incredibly useful. It walks you through the thinking process by asking a series of questions about what you would want in various scenarios. Here’s an example:

You have congestive heart failure. You are always short of breath. Your swollen ankles make walking difficult. But your mind is still sharp and you enjoy time with family and friends. One day you have a severe heart attack and your heart stops beating. Do you want 911 called and CPR started?

[  ]  Yes

[  ]  No

[  ]  I am uncertain

Their questions helped clarify my thinking. But they take it one step further, and recommend also using the questions to initiate conversation with those who will be in charge of decisions about you. To do this, they suggest giving a blank copy of the questionnaire to your agents and family members to answer the way they think you did. Comparing their answers to yours shows the discrepancies, giving you a chance to discuss and clarify your wishes. In so many cases, this sort of conversation is the missing piece in end-of-life preparations. The questionnaire process facilitates it beautifully.

You can find their planning document at the Dying with Dignity website. If you live in Canada, scroll to the bottom to find the version tailored to your province’s legal requirements. If you live elsewhere in the world, pick any province and use the booklet for the thinking process. Then do some research to learn about the legalities and appropriate forms where you live.

Some practical information…

  • A Living Will or Personal Directive does not apply to your financial decisions. It only applies to personal decisions—those about where you will live and what sort of medical care you will agree to have in various circumstances.
  • You make your Personal Directive while you are still mentally sound. In it, you specify what you want to happen to you in the time before death, and appoint someone, known as your agent, to speak on your behalf when you cannot.
  • It is a legal document that comes into effect when you have been deemed incapable of acting on your own behalf.
  • When making your Personal Directive, be sure to check the legal requirements where you live. In Alberta, a Personal Directive is optional and voluntary. However, when one is made, it must meet certain prescribed conditions to be legally valid.
  • To be legally binding, a Personal Directive must be signed, dated, and witnessed. A lawyer can do it for you, but that is not necessary as long as you research the legal requirements and follow them carefully.
  • Your Personal Directive is not written in stone. You can change your mind and write a new directive at any time. Since it does not require assistance of a lawyer, it won’t cost anything except your trouble in arranging for someone to witness your signature.

  • In Alberta, a witness MAY NOT be the person you named as your agent, the spouse or partner of the person you named as your agent, your own spouse/partner, or anyone under the age of 18 (the age of majority).
  • The witness is not required to read your document or approve its contents. The witness is there to actually see you sign the paper. That means you must complete the document except for your signature before meeting with he witness. You sign first, and then the witness signs. If ever asked, your witness would be able to swear that he or she saw you sign the document.
  • Before meeting with the witness, make several copies of the unsigned but complete directive form. Both you and the witness sign each of the copies. this means that you and your agents each have a document with original signatures, which will be helpful when they need to use it.
  • Once your Personal Directive is signed and witnessed, you may want to make copies and send them to your family. This is not legally required but will help ensure there are no misunderstandings about what you want. You may also wish to leave copies with your doctor, lawyer, and/or clergyman.

Another angle to consider…

Dementia presents a unique situation because it can take 5 to 20 years for the end of life to arrive. You might want to give thought to the kind of medical care you would want at various stages if you were to develop worsening dementia.

I recently discovered an excellent health directive for dementia with clear and direct explanations. It was developed by Dr. Barak Gaster, a medical doctor who teaches resident physicians in the clinic at the Memory and Brain Wellness Center, University of Washington. He knows a lot about the ramifications of dementia.

His Dementia Directive Form  is available free. I have just made my choices, signed and dated it, and attached it to my main Personal Directive. If you don’t yet have your Personal Directive completed, at least do the dementia directive and file it with copies of your Will and Power of Attorney. (More about what to do with all your documents at another time.)

For more about Dr. Gaster and why he thinks this is important, check out this article in the New York Times. In part, he says…

The standard advance directives tend to focus on things like a ‘permanent coma’ or a ‘persistent vegetative state,’” Dr. Gaster said. “Most of the time, they apply to a person with less than six months to live. Although it’s a terminal disease, dementia often intensifies slowly, over many years. The point at which dementia patients can no longer direct their own care isn’t predictable or obvious.

That just gives you the flavour of what a dementia directive is about. It’s worth considering.

PS I just printed the graphic with the stars and attached it to the front of my directive because I felt the document was still lacking in the spirit of what I want. I think this does it! If you’d like to print the page I used, click on the image below.

PPS Laws vary between provinces, states, and countries. I’m using information from where I live to illustrate principles, but you will need to check the details in your jurisdiction. The Internet is a good place to start.

Death Documents — The Full Picture

*** Time for this post?  Reading…5 minutes. Listening…4 minutes. Smiling…for as long as you can!

You’ve made your Will.

That’s a good thing.

Maybe you’ve asked the lawyer to prepare your Power of Attorney at the same time.

Even better.

But there’s more to consider…

Your Will and Power of Attorney direct what happens to your money and belongings.  But what about you, your person, your being?

After you’ve died, what do you want done with your body? How do you want to be memorialized? Who do you want notified of your passing? Who will know what you want? No one, unless you tell them.That’s why you should write a Last Wishes Letter.

As you age, what if you are no longer able to live alone in your home?  Where do you want to be cared for? Suppose you are very ill and in the hospital. Do you want to stay there or be moved to a hospice? Do you want medical staff to use heroic measures to prolong your life…or not? Who will make these personal decisions for you when you can’t? How will they know what to do? These are serious questions for those looking after you. You make it a lot easier for them if you’ve documented your wishes in a Personal Directive, sometimes called a Living Will, Advance Directive, or Health Care Directive)

Here’s one more scenario. Suppose, as you age, you are still mentally competent but medical appointments and information have become daunting at the same time as your medical conditions are becoming more complicated. You’d like your adult children to be able to speak to your doctor to clarify. Because of strict privacy laws these days, doctors are not at liberty to divulge information about you to anyone, not even family, unless you have completed a Supported Decision-Making Authorization.

The full picture…

So…that makes a total of five documents. Some apply when you are alive, others only after you have died. Each is important in its own sphere of influence. Here’s the full picture. Click here for a printable version.

All except your Last Wishes Letter are legal documents, but only the Will and Power of Attorney require visiting a lawyer. The Personal Directive and Supported Decision-Making Authorization  must be witnessed, but you can fill out the forms yourself and arrange to have your signature witnessed.

More about these remaining documents over the next couple weeks. In the meantime, while you digest and assimilate this big picture,  here’s something to lift your spirits…

Playing For Change is a movement created to inspire and connect the world through music. The idea for this project came from a belief that music has the power to break down boundaries and overcome distances between people. You can listen to many more of their Songs Around The World on their website.

Next week…Personal Directives. If there are questions you’d like addressed, leave them in the comment box below so I can include the answers next week.

Please note: Laws vary between provinces, states, and countries. I’m using information from where I live to illustrate principles, but you will need to check the details in your jurisdiction. The Internet is a good place to start.

Putting Your House in Order

***Time for this blog? Reading…7 minutes. Activating…up to you.

In my last blog, I talked about dealing with your things. Given today’s title, you may have anticipated ideas about sorting and distributing your possessions before you die. I will address that, but not yet. Today I want to discuss a less tangible, more abstract aspect of putting your house in order.

The paperwork…

No one’s favorite topic, I know. But if we don’t do it when we can—long before the end is in sight—we will leave a stressful mess behind.

Dealing with that mess will be much more challenging than clearing out your physical stuff. When it comes to belongings, your kids can bring in a junk removal service and have everything gone in a day so they can get your house on the market.

But…

If you don’t have your documents in place, they won’t be able to sell the house you own. That is a legal process and you must have given them the authority to act on your behalf. Without your authorization, they will have to jump through hoops to be allowed to handle your affairs. Settling your estate will cost extra time, trouble, and money.

Documents you need in place… 

How can you ensure that your survivors are able to sell your house, pay your outstanding Visa bill, and manage your investments until they legally inherit the estate? That is the role of your Will—to give authority to someone you name to wrap up your financial affairs after you’ve died. In your will, you specify how you want your estate distributed. The person who you name, known as the executor, is in charge of making it so.

And what if…

Suppose you aren’t yet dead but need your family to take over managing your financial affairs. This is a realistic possibility, given the increasing rates of Alzheimer’s and dementia these days. 

How are assets managed and bills paid in a situation where you’re physically or mentally impaired? You can’t do it, but nor can your executor because the will only comes into effect after you have died. And your bank will not allow family members to march in and take over your accounts, even if they arrive with a compelling story about your inability to do it.

On one hand, that is reassuring. But this rigorous protection of your assets works against you if you haven’t prepared for someone to take over your affairs when you are alive but incapable. That is why you need to draw up a Power of Attorney while you are still mentally sound. For all of us, this means doing it sooner rather than later.

The place to start…

There is other paperwork you need, but start with your Will and Power of Attorney. If you’ve completed these documents and recently reviewed them to be sure they are still current, you get a gold star!

If you haven’t tackled your paperwork yet, here’s a good question to ask yourself…

Why not?

What is stopping you?

Awareness is the first step toward getting these documents written. Never underestimate the motivating power of awareness. Once you know what’s standing in your way, you can do something about it and get on with the task at hand.

Often it is unconscious, unspoken beliefs that sabotage our best intentions. There are many ways to release or adjust unconstructive beliefs once we know what they are. This previous blog points you to several of those modalities.

Sometimes it is our assumptions that trip us up. Don’t we all know that “lawyers charge hundreds of dollars an hour”? The problem with assumptions is that we treat them as fact—and that stops us from finding out what the situation really is. So we become immobilized by incomplete information. If that’s your stumbling block, maybe this information will help…

  • In a quick search of “Calgary lawyers fee for wills,” I saw that lawyers are typically charging a flat fee rather than an hourly rate. For you, this means you’ll know how much the end product will cost. There are no surprises, and you can shop around to compare fees and what you get for them. The Internet has been a game-changer in this process.
  • Among the seven lawyers’ websites I looked at, flat fees for a simple will range from $400-$600. If you have complicated family relationships and/or finances, it will take more time and thus cost more. You would find that out in your initial meeting and should be given an estimate of the cost in your particular situation. You can decide then if you want to proceed or get another opinion. By the way, it is entirely your right to assess the lawyer at your first meeting and move on if you feel you can’t work with that person.
  • Ideally, a couple prepares their wills together and the documents mirror each other. Fees reflect this by charging couples less than double the amount for one person. Examples from my research, with the couples fee in brackets: $400 ($500); $500 ($750); $600 ($900).
  • Some lawyers offer a package deal for preparing your Will, Power of Attorney, and Personal Directive (Living Will). One example was $900 ($1200). Side note: It is not required that your Personal Directive (Living Will) be made by a lawyer. You can fill out the appropriate forms yourself and sign them in the presence of a witness. More about this another time.

The paperwork required to prepare for death is no one's favourite topic. But if we don't do it when we can—long before the end is in sight—we will leave a stressful mess behind. #death #dying

If this exploration reveals any insights you’d like to share… or questions you want to ask… please do so in the comment box below.

Please note: Laws vary between provinces, states, and countries. I’m using information from where I live to illustrate principles, but you will need to check the details in your jurisdiction. The Internet is a good resource for this.